NCC ELECTRONIC FETAL
MONITORING (EFM) CERTIFICATION
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. Which physiological mechanism is primarily responsible for the appearance of early
decelerations?
A. Uteroplacental insufficiency
B. Chemoreceptor response to fetal hypoxemia
C. Baroreceptor response to umbilical cord occlusion
D. Vagal stimulation due to fetal head compression
Answer: D
Conceptual Explanation: Early decelerations are caused by fetal head compression, which
triggers a vagal response, leading to a transient slowing of the fetal heart rate synchronized
with the contraction.
2. According to NICHD nomenclature, what is the required range for ‘moderate’ baseline
variability?
A. Undetectable
,B. Amplitude range of 1 to 5 bpm
C. Amplitude range of greater than 25 bpm
D. Amplitude range of 6 to 25 bpm
Answer: D
Conceptual Explanation: Moderate variability is defined as an amplitude range between 6
and 25 beats per minute, indicating a functional and oxygenated fetal central nervous
system.
3. A fetal heart rate tracing shows a baseline of 145 bpm, moderate variability, and the
presence of accelerations. How is this categorized?
A. Category III
B. Category II
C. Category I
D. Category IV
Answer: C
Conceptual Explanation: Category I tracings are normal, requiring a baseline of 110-160
bpm, moderate variability, no late or variable decelerations, and optional accelerations.
4. Which medication is most likely to cause a ‘pseudo-sinusoidal’ fetal heart rate pattern?
A. Magnesium Sulfate
B. Terbutaline
, C. Betamethasone
D. Butorphanol (Stadol)
Answer: D
Conceptual Explanation: Narcotics like Butorphanol or Meperidine can induce a pseudo-
sinusoidal pattern, which is usually transient and lacks the true undulating frequency of a
pathologic sinusoidal pattern.
5. What is the physiologic cause of late decelerations?
A. Interruption of oxygen transfer from the placenta to the fetus
B. Fetal anemia
C. Umbilical vein compression
D. Fetal sleep cycles
Answer: A
Conceptual Explanation: Late decelerations result from uteroplacental insufficiency,
where oxygen transfer is compromised during a contraction, triggering chemoreceptor-
mediated responses.
6. Tachysystole is defined as more than how many contractions in a 10-minute window,
averaged over 30 minutes?
A. 5
B. 4
MONITORING (EFM) CERTIFICATION
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. Which physiological mechanism is primarily responsible for the appearance of early
decelerations?
A. Uteroplacental insufficiency
B. Chemoreceptor response to fetal hypoxemia
C. Baroreceptor response to umbilical cord occlusion
D. Vagal stimulation due to fetal head compression
Answer: D
Conceptual Explanation: Early decelerations are caused by fetal head compression, which
triggers a vagal response, leading to a transient slowing of the fetal heart rate synchronized
with the contraction.
2. According to NICHD nomenclature, what is the required range for ‘moderate’ baseline
variability?
A. Undetectable
,B. Amplitude range of 1 to 5 bpm
C. Amplitude range of greater than 25 bpm
D. Amplitude range of 6 to 25 bpm
Answer: D
Conceptual Explanation: Moderate variability is defined as an amplitude range between 6
and 25 beats per minute, indicating a functional and oxygenated fetal central nervous
system.
3. A fetal heart rate tracing shows a baseline of 145 bpm, moderate variability, and the
presence of accelerations. How is this categorized?
A. Category III
B. Category II
C. Category I
D. Category IV
Answer: C
Conceptual Explanation: Category I tracings are normal, requiring a baseline of 110-160
bpm, moderate variability, no late or variable decelerations, and optional accelerations.
4. Which medication is most likely to cause a ‘pseudo-sinusoidal’ fetal heart rate pattern?
A. Magnesium Sulfate
B. Terbutaline
, C. Betamethasone
D. Butorphanol (Stadol)
Answer: D
Conceptual Explanation: Narcotics like Butorphanol or Meperidine can induce a pseudo-
sinusoidal pattern, which is usually transient and lacks the true undulating frequency of a
pathologic sinusoidal pattern.
5. What is the physiologic cause of late decelerations?
A. Interruption of oxygen transfer from the placenta to the fetus
B. Fetal anemia
C. Umbilical vein compression
D. Fetal sleep cycles
Answer: A
Conceptual Explanation: Late decelerations result from uteroplacental insufficiency,
where oxygen transfer is compromised during a contraction, triggering chemoreceptor-
mediated responses.
6. Tachysystole is defined as more than how many contractions in a 10-minute window,
averaged over 30 minutes?
A. 5
B. 4
